samedi 7 avril 2012

Epilepsy and depression morbidity : prevalence and management in Rwanda

Epilepsy and depression are frequent pathologies especially in the developing countries where the level of health facilities and the standards of living are very low. Scholars have stated the relationship between epilepsy and depression but with less precision on symptoms and socio-demographic variables difference.

The study (in press) assessed the co-morbidity between the two different diagnostic entities, one neurologic (epilepsy) and the other psychiatric (depression). From a purposive sample of 392 people consulting for epilepsy in Ruhengeri Hospital (Nothern Province, Rwanda), only 105 (26.7%) patients whose EEG diagnosis was positive were recruited in accordance with the inclusion criteria. Screening for depression, the Hamilton Rating Scale for Depression (HRSD) was used for the depression prevalence screening. Results from the study showed that depression is strongly associated to epilepsy with significant odds for all symptoms like depressive mood, insomnia, work and activities poor performance, anxiety, and somatic symptoms. Patients with generalized seizure are likely to suffer from severe comorbid depression as compared to patients with partial seizure. Moreover, illiterate adult women were presenting severe depression.

Epilepsy treatment should incorporate depression diagnosis and management to ensure better management of the epilepsy burden. In additional, particular attention should be given to patients presenting convulsive symptoms with non-confirmatory EEG results for an epilepsy diagnosis. In a post-genocide context, the non-epileptic convulsive symptoms may mimic TBI (Traumatic Brain Injury) symptoms or somatic complications of chronic PTSD (Post-Traumatic Stress Disorder). Future research to explore these assumptions.

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